Stress fracture of the tibia following a vascularised free fibular flap.

A 49-year-old female presented with a T4 N2 Mo moderately differentiated squamous cell carcinoma of the right cheek mucosa and involving the mandible. Patient treatment included resection of the tumour with partial mandibulectomy, maxillectomy and a free osteocutaneous fibular flap to reconstruct the bony mandibular and soft tissue intraoral defects. Six weeks postoperatively the patient developed a stress fracture of the right tibia, a complication which has not been reported in the literature previously. Pre- and postoperative measures should be considered to avoid such a complication.